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General NPI Number Information
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NPI Number | 1013147461
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Entity Type | Individual
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Provider Name | SHANNON ELIZABETH LA CAVA PSYD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 200 UCLA MEDICAL PLZ STE 502
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City | LOS ANGELES
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State | CA
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Zip | 90095-6934
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Country | US
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Telephone | 310-562-6293
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Fax |
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Provider Business Mailing Address
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Address Line | 200 UCLA MEDICAL PLZ STE 502
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City | LOS ANGELES
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State | CA
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Zip | 90095-6934
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Country | US
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Telephone | 310-562-6293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PSY27456
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License Number State | CA
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